To think that Autism/ASD is being used too freqently in toddler pre school children

[pigletmania]

I have noticed here on MN and also in real life that if a toddler/pre school child's behaviour does not conform to the 'norm' and I use the term loosely, that they must have ASD, Aspergers which is just not necessarily the case and will most probably grow out of it in their own time.

Children from a very young age are under constant assessment and scruitny which does not allow for individual personality differences, and does not allow for the child to develop in at their own pace. They are not robots but inividuals! Of course I understand that there are young children with real difficulties that do need help and intervention and don't dispute that. I use my own dd 3.5 as and example.

We self referred her to SALT this April as we were concered about her social communication and also pressure from friends and relatives. DD goes to a pre school too and they were concerened about it too so have referred her onto ED Psych. DD is quite shy like dh and did not like to communicate to different people especially ones that she does not know, she finds it difficult to make conversations and initiate them (she is only 3 fgs). She loves other children but does not know what to say to them and does not always make eye contact.

The SALT came on Monday as a follow up and suggested a referral to a Paedritrician(sp) and talked about possibility of ASD wtF!!!!!! We declined at the moment. Since the SALTS first assesment at the beginning of July we have noticed progress in dd interaction and the way in which she communicates. She now makes eye contact and has made efforts to communicate to other children, nothing at a bit of time and help from SALT and Ed psych will sort out. Why te Paedritrican fgs. Just because she needs a bit of help with her social communication does not mean she needs the paedritrican and she has ASD. She is still young and is learning all the time.

There is so much expectation of people so young. Its expected that they be potty trainned, feed themselves, and communicate like adults before 2! Sorry for the long post btw

pigletmania, I've been doing some washing up and thinking about your situation. This feels like intefering and I hope you don't mind, but I really want to urge you to see the paediatrician - basically because of my own personal experience, so please feel free to disregard my post totally if you feel this is not relevant to you.

I went through school with undiagnosed dyspraxia (actually, this condition never was diagnosed in the seventies!) I still feel a bit hurt that my mum didn't take my difficulties seriously. I was very successful academically but I struggled at school in ways that still hurt to remember - particularly socially. At one point I was referred to an Ed Psych but my mum refused to take me because she felt there couldn't possibly be anything wrong with me.

I wish I had had some help! It seemed that I had to try twice as hard as everyone else to make my work neat, and to understand what was going on, follow instructions etc. I am still clumsy and disorganised and my handwriting is still terrible. My social skills are okay-ish but perhaps a little bit strange and I have to work hard at them. I wish that somebody that told me it was okay to be the way that I am and that there was a 'label' to explain it - perhaps I would not have felt so inferior for so long.

I suppose what I am trying to say is: don't deny your DD a label if she really does need it. Labels are 'only' labels and if she does by any chance turn out to have a label, that won't change the very precious individual that she already is - it just might mean she gets support instead of struggling unnecessarily.

The good thing about a referral to a Paed is that they will be looking at all areas of development rather than just one particular area like a SALT will.

With my ds1 I would've said that the main issue was his language and communication skills, and his lack of social awareness. Once the assessment process started it soon became obvious that there were other major difficulties that no-one else had ever picked up on, particularly to do with motor skills and sensory issues. Without that 'whole child' approach I think the outcome for ds1 would have been very different.

I agree too about the issue of making progress. My two with ASD have made huge amounts of progress over the years, but the ASD is still very much there.

I have experience of people like the OP in real life. The ones I DO know in RL are very much in denial of their child who is clearly showing strong traits of autism.

I'm not suggesting that this is true in the OP's case BUT....

Far better to have your mind put at rest OR have the appropriate interventions put into place to help than not imho.

But then I'm firmly of the belief that it's not my kids' autism that is the problem, it's other people's perceptions and the blocking of support services to help them that weighs most heavily upon me.

Thanks for your advice everybody especially greenbananas and coppertop . I really dont want to offend anybody and thats not my initention just my musings thats all. I did also so that if your child does have difficulties like those highlighted on here than they should get help and intervention. I guess also I am scared about what the outcome might be. I have Dyslexia and dyspraxia myself and yes I would have benefited from early intervention at school, I was assesed and diagnosed when I was 19 at college, but still managed to get my BA and MSc. I would like to wait for the Ed Psych assessment and if they feel that dd would benefit from a referral to Paed than we would, we just also wanted dd to develop in her own time. The report from dd initial SALT assesment came through this week, and does not read the same as she has made significant progress on the social communication front. She is initiating conversations more, making more observations, and is interacting with us more. I have not said that we wont give premission for a referral, just that we will deferr it and wait a few months as we feel and also the pre school have noted that she is getting so much better at communicating.

No she is not the same in the social communication front as some of the other children her age, but like adults we differ, some commiunicate more than others. DD is very intersted in her envirnoment and surroundings and makes observations to us about all manner of things and does not mind not sticking to a routine really.

Ds's school flagged concerns re ASD.

I have heard a million and one versions of "all naughty kids are labelled ASD these days."

it's crap! DS is NOT AT ALL naughty. Far from it, he is TOO compliant, he LOVES a rule, it was not difficulty to manage him that lead to the suggestion, it was a whole combination of other things, social issues, lack of creativity, exceptional ability in certain areas, obssessiveness, routine focussed to a painful degree etc etc etc.

I have cried and cried that it seems highly likely that DS IS on the spectrum. (we're waiting for our referral, early help means a better chance fo a successful adulthood imo) but for all I read, the MORE likely it seems.

But I am pleased that the school paid enough attention to ds to spot things I may have dismissed as I don't know enough about "usual" and also flagged things we HAD noticed but didn't know what to do...

I think if someone I had ASKED for help suggested some help, I would think very carefully before turning them down. I also think it is very unthinking to phrase your OP in such a way that people who have children on the spectrum MIGHT feel bad.

And, yes Einstein didn't speak until he was four - most people who know about his personality now conclude he was actually on the spectrum. After all, no one said autistic means stupid, did they?

Sorry, x posted with your last... sorry if I was a bit shouty there!

Pigletmania, I think YABU to brush this referal under the carpet until you seem fit that your DD needs it. A Paed will not only be looking at ASD, but if there are any other cause for concerns regarding your DD. Your daughter might not have ASD, she might not have anything "wrong" with her, but if there is a DX to be had then there is no harm getting one. Early intervention with social/communication disorders are important.

I can see you've done the first steps towards helping your DD, so I can't understand why not the paed. To me it seems you're burying your head in the sand. You almost sound disgusted that the SALT dare suggest ASD.

My DS2 has autism and I can assure you it isn't anything to fel ashamed about. The more help he gets the better, and a DX is the only way he got this help.

As a parent of two with autism, both diagnosed before they reached the age of your dd and rightly diagnosed too. I would urge you to see a paediatrician, your dd will not get a diagnosis if she doesn't fulfil a very specific criteria but she may benefit from some early intervention and you may benefit from being taught strategies to aid her progress.
You say yourself you have dyslexia and dyspraxia both thought to be related ASD conditions and would have benefited from help at school.Let your dd be seen and secure any help now before she starts school would be my advice.Why wouldn't you want your dd to recieve every support available?

YABU. My Mum was a learning support teacher in a primary school for many, many years. She has always said that, if there is a problem, it's best picked up early because they have time to do something about it. If it's left undiagnosed, then they miss opportunities for specialist treatment in the early years, which are the really important years. If there is an issue, you've got the SALT to thank for picking it up early, if there isn't, then that's a good outcome too, of course.

Pigletmania, even after your last post I still think YABU. Why did you self-refer your DD to the SALT if you weren't prepared to accept their advice? If you do end up accepting the referral to the paediatrician, will you accept their advice either?

You don't seem to have fully understood Tiredmumno1's point. Of course everyone's different, but professionals already account for that and raise concern when they see a significant difference. I thought my own autistic son would catch up, and if he ever does it will be a bonus, but for his sake I have to accept that may never happen.

Obviously I don't know what it's like in your area but there's a year's wait between referral and assessment in mine. Don't forget that starting school is a whole different ball game for children with social communication difficulties. What happens if you add a few months on beforehand and DD is struggling in the meantime?

You were "lucky" to be diagnosed even as late at 19 and lucky to have your BA and MSc. There is a part of me which will never forgive my mother - a qualified special needs teacher at my school - for not having me assessed when she could. I wasn't diagnosed with autism and dyspraxia until I was 27 so I am now over a decade behind my peers - in terms of education and life opportunities in general.

No, I am not you, but your DD is not you or your DP either. Of course we'd like to think that things will be much easier for our children in the future than they were for us, but as it's not a given, why would you take the chance of your DD going through anything like the same?

I see what you mean, and maybe some people are too quick to label a child with a disorder when they're just shy or whatever, but that's quite possibly more a fault of the general population than health professionals (at least I hope so).

I agree with those who have emphasised the importance of early diagnosis, my brother was diagnosed with ASD in his late teens and I think it would have made a huge difference to him now if he could have had that earlier, he went through a truly awful time of being disciplined and in trouble at school for not behaving properly and being 'disruptive', being subjected to very bad verbal and physical bullying, leading into self-harming and depression and pretty much 'dropping out' of society, and falling behind with schoolwork (though he is intelligent). My parents also suffered with not knowing what was wrong and blaming their parenting skills, sometimes I'm sorry to say being angry and hurtful towards him themselves for getting into trouble and embarrassing them, not behaving 'normally' in public etc. He was often angry and upset with himself for not being able to fit in or please, and not understanding why.

Diagnosis or professional support starting at your DD's age would not necesssarily have prevented all the above problems, but surely it would have helped all round to have had some understanding of what the problem was, and some interventions and support to help him (and our parents) to cope with his particular difficulties? If you think your DD is fine and happy and doesn't need any additional help, then that's great, and you shouldn't feel pressured. I was shy as a little girl too, and struggled with speaking up in public and socialising for a long time, it's not unusual. But I don't agree with your rant against early assessment and looking for ASD in young children.

I see what you mean, and maybe some people are too quick to label a child with a disorder when they're just shy or whatever, but that's quite possibly more a fault of the general population than health professionals (at least I hope so).
It is very difficult to get an ASD diagnosis particularly in a pre schooler because the diagnostic process does take into account the wide variation in normal and a child does need to meet a very specific criteria.It would be very unlikely that a child with a diagnosis didn't meet the diagnosis as if for no other reason professionals are reluctant to diagnose early anyway in my experience as it does cut down on the demand for resources.

Thanks everyone for the great advice . Just considering the options really

Thanks mumi for taking the time to read my posts

i thought maybe the op just missed them.

In my experience, most people involved with preschoolers downplay their issues.

My DD was described as 'just a bit immature' by the Area Inco. I insisted on a referral to the Paed, which would have taken months.

Fortunately for DD1 she started falling over soon after, which got us sent to the hospital as an emergency. She got fast-tracked onto our Paed's list that day.

DD1 has a brain malformation. She has some ASD traits, but our Paed (who specialises in ASD) doesn't agree that she has ASD. I think she will get a dx eventually.

It took 9 months to reach the top of Portage waiting list

It took 6 months to reach physio waiting list

It took 8 months for OT to kick in

It took 7 months for her Maclaren Major to be resourced from OT referral.

I have just done DD1's DLA renewal. I submitted 27 reports and she still hasn't got one of those ASD labels that get thrown at preschoolers like toffees

DS1 was first flagged as a concern at 18 months. He was given a diagnosis of ASD this year, at 4 years 10 months.

I am completely and utterly sick of the weird dichotomy in the world - professionals are all telling me there is something "wrong," lay people all telling me it is "completely normal" and doing lots of because, well, he looks normal, he's just naughty.

DS1 has a tested IQ of over 130 - but he can't speak well, or use a toilet properly without help, or walk very far.

When we got the diagnosis (and I formally accepted it, which was a good three weeks after it was given) several professionals told me he would have benefited from early intervention, and if he had had effective early support, he probably wouldn't have severe enough symptoms now to need a label.

I am not sure they should have said that, when it was too late, it couldn't do anything but make you feel awful.

DD has been in system for nearly 2 years and still no DX, she is allegedly getting support but it's not great.

crunchy - you should take that with a pinch of salt. If anyone told me that they could predict outcomes I would take that as a sure sign that they were both unprofessional and a twat.

I sympathise with your situation Piglet but I can't agree with your OP.
The number of children who can't get a diagnosis outweighs by a tonne the number of children being flagged for the wrong reasons.
And I don't think there are many children getting a diagnosis at that age erroneously.

The whole world actually spends its time tryingto persuade anxious parents out of their genuine concerns. Mostly I think because the public just want to reassure and not talk about bad shit. And professionals don't want to diagnose unless they are absoloutely sure. And LEAs sure as shit don't want more children who need extra support.

It's actually VERY difficult to get a diagnosis, it's really a long process. Far more often it's the other way round - NOT seeing autism and leaving the child unsupported! Going round pointing and saying THAT child didn't look at me AUTISTIC! THAT child lined up those toys-AUTISTIC! THAT child didn't say hello to me-AUTISTIC... well, it just doesn't happen like that.

It is always better to investigate any sign that is a 'red flag'. If it is nothing, then it's nothing and it goes no further. A child is not harmed, damaged or affected in any way by checking out a possibly issue. However, a child is very disadvantaged and affected by ignoring a sign and not investigating, because then if there is something, they're not helped. Investigating doesn't give a child autism. The team are very keen to walk away as soon as they establish that there's no issue, trust me! There's too little time, money and resources to go round those who DO need them, let alone pull in those who don't!

Thanks for your posts reallytired I did read them, just considering the options really.

I think it' also very important to trust the professionals you're working with. If you don't like the paediatrician you're referred to (or the SALT or ed psych or anyone) then it's important to get a second opinion. I realise referrals on the NHS & in the educational system are hard to get but if you get to the point that a paed tells you something that doesn't feel quite right & doesn't answer your concerns, then it's well worth dishing out the money to go privately to a developmental paediatrician just this once. A good professional would never, ever ever offer a diagnosis of ASD lightly (or of anything else, really; although as I've written before I really think ADHD happens to be overdiagnosed, but that's another story). A lot of other things would be considered and ruled out first before ASD is suggested.

My son went through about 9 months of assessments with various professionals. It was a heart breaking and stressful time. It was a real blessed relief when we found out what the real problem was.

I think a community paediatrian is a great idea. He/ She will look at your child holistic. Your child will play in their office while she chats to you for about an hour. A good paediatrian will see your child on more than one occassion and discuss your child with other professionals before making any diagnosis.

Our paediatrian helped my son in so many ways. She also supported us emotionally. I had a mixture of emotions when finally my son was discharged from her care.

My son did really well in his SATS at the age of seven. (level 3s in reading and maths, although 2 c for writing. Sorry if this seems boasting, but I want to make it clear that developmental delay doesn't necessarily mean a child has learning difficulties or won't catch up.) He also has lots of friends and enjoys life to the full.

Yet he was a little boy who at 23 months could only manage to walk two steps and had virtually no speech. Our paediatrian determined that he had orthopedic problems and glue ear. Yet these two minor problems made him look very disabled.

I believe that my son would not have achieved so much without early intervention.